Article

Comparison of Long‐Pulsed Diode and Long‐Pulsed Alexandrite Lasers for Hair Removal: A Long‐Term Clinical and Histologic Study

Authors:
  • Washington Institute of Dermatologic Laser Surgery
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Abstract

Background: Unwanted facial and body hair is a common problem, generating a high level of interest for treatment innovations. Advances in laser technology over the past several years has led to the development and distribution of numerous red and infrared lasers and light sources to address this issue. Despite the impressive clinical results that have been reported with the use of individual laser hair removal systems, long-term comparative studies have been scarce. Objective: To compare the clinical and histologic efficacy, side effect profile, and long-term hair reduction of long-pulsed diode and long-pulsed alexandrite laser systems. Methods: Twenty women with Fitzpatrick skin types I-IV and dark terminal hair underwent three monthly laser-assisted hair removal sessions with a long-pulsed alexandrite laser (755 nm, 2-msec pulse, 10 mm spot) and a long-pulsed diode laser (800 nm, 12.5 msec or 25 msec, 9 mm spot). Axillary areas were randomly assigned to receive treatment using each laser system at either 25 J/cm2 or 40 J/cm2. Follow-up manual hair counts and photographs of each area were obtained at each of the three treatment visits and at 1, 3, and 6 months after the final laser session. Histologic specimens were obtained at baseline, immediately after the initial laser treatment, and 1 and 6 months after the third treatment session. Results: After each laser treatment, hair counts were successively reduced and few patients found it necessary to shave the sparsely regrown hair. Optimal clinical response was achieved 1 month after the second laser treatment, regardless of the laser system or fluence used. Six months after the third and final treatment, prolonged clinical hair reduction was observed with no significant differences between the laser systems and fluences used. Histologic tissue changes supported the clinical responses observed with evidence of initial follicular injury followed by slow follicular regeneration. Side effects, including treatment pain and vesiculation, were rare after treatment with either laser system, but were observed more frequently with the long-pulsed diode system at the higher fluence of 40 J/cm2. Conclusion: Equivalent clinical and histologic responses were observed using a long-pulsed alexandrite and a long-pulsed diode laser for hair removal with minimal adverse sequelae. While long-term hair reduction can be obtained in most patients after a series of laser treatments, partial hair regrowth is typical within 6 months, suggesting the need for additional treatments to improve the rate of permanent hair removal.

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... Printed material is a straightforward and economical instrument that can easily be dispensed to patients in any elective clinical setting. It has been shown that such intervention does improve patient understanding and recall of their treatments and its related complications [38][39][40][41][42]. Other studies have established the presence of lower anxiety levels in patients undergoing surgical procedures and improved overall satisfaction with their management with the use of written material [43,44]. ...
... • Stimulation of cellular turnover [40] • Reactive flaking In addition, the caustics stimulate the synthesis of growth factors [41], stress proteins and cytokines [42][43][44], which cover a fundamental role both in dermal remodeling and in the control of the acneic process. ...
... "Spread" occurs immediately after the injection itself, which is related to technique, volume of injection, and needle size. "Diffusion" occurs over several days as the toxin passively moves away from the injection site [42]. Generally Azzalure ® /Dysport ® has a larger area of action, and there has been ongoing debate regarding the difference in onset between Botox Cosmetic ® /Vistabex ® and Azzalure ® /Dysport ® [43]. ...
... A number of comparative studies have been conducted to ascertain which of the medium-wavelength lasers, namely the alexandrite and diode, is most effective and safe, but their results have been conflicting. Indeed, while a number of authors have found equivocal efficacy [5][6][7], support for the superiority of the alexandrite laser [8] and, conversely, for the diode laser [7] has also been reported. Part of this discrepancy can be explained by a short follow-up period ( 6 months) for all but one of these studies [6]. ...
... A number of comparative studies have been conducted to ascertain which of the medium-wavelength lasers, namely the alexandrite and diode, is most effective and safe, but their results have been conflicting. Indeed, while a number of authors have found equivocal efficacy [5][6][7], support for the superiority of the alexandrite laser [8] and, conversely, for the diode laser [7] has also been reported. Part of this discrepancy can be explained by a short follow-up period ( 6 months) for all but one of these studies [6]. ...
... The images were then loaded onto a computer, and the TrichoScan 1 software was used to analyze hair density (n/cm 2 ). Pain, perifollicular edema, and erythema were quantified by the physician using visual analog scales [1][2][3][4][5][6][7][8][9]. Patients were followed up for long-term assessments at 6 and 18 months after the final treatment session. ...
Article
Alexandrite and diode lasers are commonly used for hair removal. To date, the available spot sizes and repetition rates are defining factors in terms of penetration depth, treatment speed, and efficacy. Still, larger treatment areas and faster systems are desirable. To compare the efficacy, tolerability, and subject satisfaction of a continuously linear-scanning 808 nm diode laser with an alexandrite 755 nm laser for axillary hair removal. A total of 31 adults with skin types I-IV received 6 treatments at 4-week intervals with a 755 nm alexandrite laser (right axilla) and a continuously linear-scanning 808 nm diode laser (left axilla). Axillary hair density was assessed using a computerized hair detection system. There was a significant reduction in axillary hair after the 6th treatment (P < 0.05) on both sides (left, 808 nm: hair clearance of 72.16%; right, 755 nm: hair clearance of 71.30%). The difference in reduction between the two lasers was not significant, but both were persistant at 18 months follow-up (left: hair clearance of 73.71%; right: hair clearance of 71.90%). Erythema and perifollicular edema were more common after alexandrite laser treatment, but all side effects were transient. While 62.50% of patients reported more pain in response to treatment with the new diode laser, all patients rated treatment with either laser tolerable. Treatment with either the alexandrite or the linear-scanning diode laser results in significant, comparable, persistent (at least 18 months) axillary hair reduction among individuals with skin types I-IV. Lasers Surg. Med. © 2013 Wiley Periodicals, Inc.
... There have been many non-RCTs (39)(40)(41)(42)(43)(44)(45) and RCTs (38,(46)(47)(48)(49)(50)(51) on the efficacy of laser and IPL-based hair removal previously, most of which only follow participants short term (39,41,42,45). There is evidence that some trial (51) definitions of "long-term" hair reduction fail to take into account the sitespecific periods of hair growth cycles of the areas they measured long-term hair reduction for. ...
... There is evidence that some trial (51) definitions of "long-term" hair reduction fail to take into account the sitespecific periods of hair growth cycles of the areas they measured long-term hair reduction for. An RCT by Handrick et al. (51) targeted underarm hair with follow-up 6 months from last treatment; however, the growth-cycle for under-arm hair has been found to be 7 months (22); therefore, follow-up at 6 months cannot provide a true measure of "long-term" hair reduction. There was heterogeneity in body site treated in some trials including Lin et al. (41), who compared 694 nm Ruby with 800 nm Diode and targeted abdomen, buttock, back, shoulder, forearm, upper arm, thigh, and lower leg. ...
Article
Full-text available
Laser and light-based devices provide scope for long-term "hair-removal" however, there is limited evidence supporting their long-term efficacy. This study aimed to assess the long-term efficacy of laser and light-based "hair-removal" devices, taking into account variations in body site-specific variations in hair growthcycles. A systematic review of randomized controlled trials (RCTs) with follow-up periods greater than or equal to the length of one complete hair growth cycle in the body site targeted was conducted. Only five eligible RCTs were identified as suitable for inclusion, and these comprised a total of 223 patients. The average long-term hair reduction reported for neodymium:yttrium-aluminum-garnet (Nd:YAG) laser ranged from 30 to 73.61%, Alexandrite laser ranged from 35 to 84.25%, and Diode laser ranged from 32.5 to 69.2%. In all three devices, the greatest long-term reduction was observed from trials targeting leg hair (1-year growth cycle) and lowest from targeting facial hair (6-month growth cycle). Intense pulsed light (IPL) produced average long-term hair reduction of 52.7-27%; smallest reduction was observed from targeting the face area and greatest from targeting the axillary area (7-month growth cycle). In conclusion, greater long-term hair reduction was observed on body sites with longer hair growth cycles. Future trials should take into account the varyiation of hair growth cycles across body sites to provide accurate long-term data on treatment outcomes.
... A number of comparative studies have been conducted to ascertain which of the medium-wavelength lasers, namely the alexandrite and diode, is most effective and safe, but their results have been conflicting. Some of these studies reported equal efficacy [9], while others showed the alexandrite or diode lasers to be more effective [10][11][12]. However, in case of darker skin, there is some evidence that long pulse diode laser with high repetition rate and high average power is safer and more effective, since the use of traditional alexandrite 755-nm laser may pose clinical challenge in dark skin due to its high peak power [13]. ...
... Although a number of lasers and non-laser light sources have been developed for hair removal, the 755nm alexandrite and 800-810-nm diode lasers remain common options for this purpose among individuals with Fitzpatrick skin types I-IV [15,17]. Several clinical studies conducted to compare these two laser systems, indicated various benefits of each system as well as their limitations [9][10][11]. Recently, highpower laser diodes emitting at 755 nm, the same wavelength as alexandrite, are available and have made their way into new hair removal systems. ...
Article
Full-text available
The aim of this study was to compare the efficacy and safety of a novel diode system emitting 755 nm wavelength with conventional 755 nm alexandrite laser in skin types III and IV. It was a randomized, right-left comparison, assessor-blind, clinical study. Sixteen female volunteers age 29.52 ± 9.52 were randomly assigned to receive six treatment sessions using 755 nm diode laser on one axilla and 755 nm alexandrite on the opposite axilla. Efficacy was assessed by counting of hairs per square centimeter, 6 months after the last treatment. Treatment outcome was also evaluated by blind reviewing of before and after pictures, using Physician Global Assessment scale (GAS). Subject satisfaction was assessed using visual analogue scale (VAS), pain level and adverse effects were recorded. Skin biophysical parameters (transepidermal water loss, skin sebum, and erythema index) were also measured. Significant reduction in hair count was observed, 6 months after the last treatment session, for both devices (− 33% for 755 nm diode and − 35% for 755 nm alexandrite; p value = 0.85). The mean GAS score was 2.66 for alexandrite treated side vs. 2.00 for diode treated side (p value = 0.036). No severe adverse events were reported. The subject satisfaction score was significantly higher after treatment with alexandrite laser. No significant changes were detected in none of skin biophysical parameters. 755 nm diode laser is suitable for hair removal procedures and it is as effective and safe as the 755 nm alexandrite laser in skin types III–IV.
... Hawkins et al 20 have reported that the visible red and infrared wavelength revealed to have highly absorbent and unique therapeutic effects in vivo tissues. In the visible to near-infrared wavelength, melanin is the main chromosphere for targeting hair follicles, where the diode 808 -nm laser is absorbed by melanin with deep penetration into the dermis layer 21 . The use of lasers in hair removal allows selective targeting of the hair bulb and can diminish regrowth for at least three months. ...
... 50 %ige Reduktion der Haare nach 6-20 Monaten nach Behandlung gezeigt werden [9,12,[14][15][16]. Bei hellen Hauttypen (I-III nach Fitzpatrick) zeigten verschiedene Studien für Dioden-, Rubin-, Alexandrit-Laser und IPL-Systeme eine vergleichbare Effektivität [16][17][18][19][20][21], wobei für IPL und Rubin-Laser insgesamt nur spärliche Langzeitdaten vorliegen [12]. [24]. ...
Article
Zusammenfassung Die Fotoepilation zählt zu den meistgefragten nichtchirurgischen Eingriffen in der ästhetischen Dermatologie. Haarlose, glatte Beine gelten dabei als Schönheitsideal. Fotoepilation mittels Laser oder hochenergetischer Blitzlampen (sog. Intensed-Pulsed-Light-Geräte) stellt ein sicheres und effektives Verfahren dar. Der Wirkmechanismus beruht auf dem Prinzip der selektiven Fotothermolyse, wobei eine gezielte thermische Schädigung pigmentierter Haarfollikel unter Schonung des umliegenden Gewebes erfolgt. Melaninpigment des Haarschaftes absorbiert als Zielchromophor Licht eines speziellen Wellenlängenspektrums und führt durch Wärmediffusion zur Schädigung der für das Haarwachstum wichtigen Stammzellen im äußeren Haarwurzelschaft. Patienten müssen über die Notwendigkeit wiederholter Behandlungen sowie den häufig nur partiellen und temporären Haarverlust aufgeklärt werden. Dunkle Terminalhaare bei hellen Hauttypen lassen sich effektiv entfernen. Bei dunklen Hauttypen besteht aufgrund des erhöhten epidermalen Melaninvorkommens ein erhöhtes Risiko für Nebenwirkungen wie Verbrennungen, Dyspigmentierungen und Narben. Sehr feine, helle oder rote Haare lassen sich kaum mit konventionellen Fotoepilationsverfahren entfernen. Haarentfernungsgeräte für den Heimgebrauch sind eine kostengünstige, einfach anzuwendende Alternative, weisen aber im Vergleich zur professionellen Fotoepilation eine geringere Effektivität auf.
... Patients were required to complete a questionnaire according to a digital scale on the degree of pain felt during treatment at each session. The degree of pain was ranked from 0 to 10 in accordance with the Numeric Pain Intensity Scale: very high,10-8 high, 7-5 average, 4-2 and low (1-0). At the 12 to 14 month follow-up, patients were also asked to report their grade of satisfaction and degree of improvement in the quesionnaire. ...
Article
Full-text available
This retrospective cohort study regarding hair removal procedures considers all the data collected in three different clinical centers from 2017 to 2019. The device used to perform the treatments was composed of an Alexandrite 755 nm and an Nd:YAG 1064 nm laser, that delivered both wavelengths in a blended simultaneous emission (Thunder MT, Quanta System, Samarate, Italy). The improvement evaluated after 5 sessions of treatment by an external referee was: 83.0% for armpits, 82.1% for the bikini line, 82.2% for legs, 79.6% for thorax and 81.6% for the back. The collected temporary skin reaction data reported in this study were all acceptable and transitory resolving in less than one week. The level of erythema and perifollicular edema were all signs of the reached treatment endpoint. First degree burns, hyper and hypopigmentation were also reported in a few cases but these, all resolved before the follow‐up visit without any permanent skin effects. No adverse effects were thus reported to have happened. This retrospective study demonstrates the efficacy of combining Alexandrite and Nd:YAG lasers in a mixed modality with simultaneous emission. This technology permitted to treat patients with skin types I‐V without any reported permanent side effects and with a high pain tolerability compared to the use of Nd:YAG in single mode. This article is protected by copyright. All rights reserved.
... It has been observed that intra-and post-operative pain is rated mild to moderate with the alexandrite laser but moderate to severe with the diode laser. 25 It has already been reported that axillary bromhidrosis and hyperhidrosis improve with laser application. 26 But these complaints have lately been reported as new side effects of hair removal lasers. ...
Article
Introduction: The axillary hair removal laser is one of the most often used procedures to treat unwanted hairs in that region. Employing this technology can be helpful in decreasing the bromhidrosis. Methods: In the present research, a clinical trial study over the effect of the hair removal laser on normal microbial flora at the axillary region is presented. The intervention group consisted of 30 women referred to the dermatologic clinic for the purpose of removing axillary hair by the alexandrite 755 nm laser and the control group consisted of 30 women referred to the same clinic for any other reasons. Both groups were evaluated for the type of bacterial strains on the first visit and after three and six months. Results: The results showed that the sense of sweat smell improved by about 63% after the last laser session. The frequency of all bacterial strains decreased in the intervention group except Staphylococcus epidermidis which was significant. In the control group, there was no significant decrement in any bacterial strains and even the prevalence of more strains including Staphylococcus aureus and S. epidermidis increased. Counting the mean bacterial colon showed a slight decrement of the bacterial count following the laser. Conclusion: The use of laser radiation, even with the aim of hair removal, can alter the microbial flora, and it can be accompanied by the improvement of the smell of sweat. The effect of the laser on different bacterial strains is quite different, which can depend on the amount of energy, the wavelength, the characteristics of the area under the laser, and also the structural properties of the membrane of the microorganism itself.
... Due to the incomplete report of the data in the study by Handrick, the standard deviation of the data was not measurable, and therefore meta-analysis was not applicable (Handrick and Alster, 2001). Therefore, the result of the most powerful study, that is the one conducted by Toosi which had a lot of participants, is considered as the base for the treatment (Toosi etal., 2006). ...
Article
Full-text available
Introduction: Excessive hair removal is one of the issues discussed specifically in cosmetics. To this end, various methods are available, such as the electrolysis, chemicals, etc., but each of these methods provides advantages and disadvantages. Alexandrite laser device laser is one of the most popular systems available and suitable for skin type’s I–IV. In this study we aimed to evaluate this device to determine whether it can be used as an alternative device for other devices. Materials and Methods: A comprehensive search was conducted in 6 July 2019 via Medline (PubMed), Cochrane Library, Scopus, CRD, NIHR HTA, web of science, Clarivate and ProQuest databases using PICO-based selected keywords. Afterwards, the retrieved studies were selected by two reviewers. Studies with no inclusion criteria were excluded. Then, selected studies were assessed by two evaluators using CASP International tool. Finally, five studies were selected and the obtained data were meta-analyzed by RevMan 5.2 software. In order to compare the costs and outcomes, the Incremental Cost-effectiveness Ratio (ICER) index and the sensitivity analysis were implemented. Results: This method is effective and safe. Short-term complications in Diode laser are more than the Alexandrite, Whereas Nd:YAG lasers and Intense Pulsed Optical Systems(IPLs) generally show less complications than Alexandrite. Patient satisfaction was not different between any of the methods. There was no difference between the long-pulsed Alexandrite laser, Diode laser, and IPL systems in light of therapeutic effects, but the only significant difference was seen in reduction rate of the mean amount of hair. The long- pulsed Alexandrite laser reduced it 16.62% more than the Nd:YAG laser. Keywords: Alexandrite laser, Incremental Cost-effectiveness Ratio, Diode laser, Intense Pulsed Optical Systems
... 113 LP ruby (694 nm), alexandrite (755 nm), diode (800 nm), and Nd:YAG (1,064 nm) lasers as well as IPL (590-1,200 nm) have been shown, through numerous published studies, to achieve long-lasting hair reduction with a low incidence of adverse effects. 110,[114][115][116][117][118][119][120][121][122][123][124][125][126][127][128] The optimal laser or IPL selection is determined by the patient's skin type. The LP ruby laser is best used in pale-skinned patients with Fitzpatrick skin phototypes I-III, 114 whereas the LP alexandrite and diode lasers can be safely used in individuals with slightly darker skin (Fitzpatrick skin phototypes I-IV). ...
Article
Full-text available
The role of light-based technologies in dermatology has expanded dramatically in recent years. Lasers and intense pulsed light have been used to safely and effectively treat a diverse array of cutaneous conditions, including vascular and pigmented lesions, tattoos, scars, and undesired hair, while also providing extensive therapeutic options for cosmetic rejuvenation and other dermatologic conditions. Dermatologic laser procedures are becoming increasingly popular worldwide, and demand for them has fueled new innovations and clinical applications. These systems continue to evolve and provide enhanced therapeutic outcomes with improved safety profiles. This review highlights the important roles and varied clinical applications that lasers and intense pulsed light play in the dermatologic practice.
... It is worth noting that the hair clearance after three treatment sessions had decreased at 3 months after the final treatment, compared with that at 1 month, and then increased again at 6 months in the three subjects who were followed for up to 6 months after completing the three sessions (Fig. 2B). Similar results were observed in previous studies 21,22 . The reduced clearance at 3 months could be explained by treatment-induced synchronization 21 ; most hair follicles enter the telogen phase shortly after laser treatment and then the anagen phase simultaneously about 3 months later, temporarily appearing to have low hair clearance and more hairs. ...
Article
Full-text available
Background: The efficacy of the long-pulsed diode laser (LPDL) in hair removal is determined with various physical parameters. Recently, LPDLs with a larger spot size are commercially available; however, the independent effect of spot size on hair removal has not been studied. Objective: This study aimed to compare the efficacy of the LPDL in hair removal depending on the spot size. Methods: A randomized, evaluators-blind, intrapatient comparison (left vs. right) trial was designed. Ten healthy Korean women received three hair removal treatment sessions on both armpits with the 805-nm LPDL and followed for 3 months. A 10×10 mm handpiece (D1) or a 10×30 mm handpiece (D3) was randomly assigned to the right or left axilla. The fluence, pulse duration, and epidermal cooling temperature were identical for both armpits. Hair clearance was quantified with high-resolution photos taken at each visit. Postprocedural pain was quantified on a visual analogue scale. Adverse events were evaluated by physical examination and the patients' self-report. Results: The mean hair clearance at 3 months after three treatment sessions was 38.7% and 50.1% on the armpits treated with D1 and D3, respectively (p=0.028). Procedural pain was significantly greater in the side treated with D3 (p=0.009). Serious adverse events were not observed. Conclusion: Given that the pulse duration, fluence, and epidermal cooling were identical, the 805-nm LPDL at the three times larger spot size showed an efficacy improvement of 29.5% in axillary hair removal without serious adverse events.
... Most studies comparing the long-pulsed alexandrite and the long-pulsed diode lasers show almost equal efficacy and tolerability. 5,6,14,15 Given the sample size and 2-month follow-up, it is difficult to draw any conclusions about the disparity in lasting effects. ...
Article
Full-text available
BACKGROUND: The 755-nm alexandrite and the 1,064-nm Nd:YAG lasers are both utilized for hair removal. Advances in laser technology have led to the development of dual-wavelength treatment for increased efficacy. OBJECTIVE: The objective was to evaluate the safety and efficacy of combining 755- and 1,064-nm wavelengths for axillary hair removal. METHODS: Twenty patients received three treatments at 4- to 6-week intervals in four axillary quadrants. The left upper axilla was treated with the alexandrite laser, the left lower axilla with the Nd:YAG laser, the right upper axilla with combination alexandrite and Nd:YAG laser, and the right lower quadrant with the diode laser. At 1- and 2-month follow-up visits, subjects completed questionnaires and were assessed for percentage of hair reduction. RESULTS: Eighteen subjects completed the study. The greatest reduction was seen with the alexandrite laser at 70.3% and combination of alexandrite and Nd:YAG laser at 67.1%. The diode laser was less efficacious at 59.7% and the Nd:YAG laser had the least improvement with 47.4% reduction. Subjects found the alexandrite and diode lasers to be the most tolerable and the Nd:YAG and combination treatment to be the most painful. CONCLUSION: Combination treatment of alexandrite and Nd:YAG lasers provides no added benefit over the alexandrite laser alone.
... The effectiveness of the 755 nm Alexandrite laser for photo-epilation has been substantiated by many studies. 12,13,14,15 Color contrast between the epidermis and the hair shaft and bulb are critical in determining the optimal wavelength. 8 For high contrast (dark hair, light skin), the 755 nm wavelength can be used with minimal risk of damage to the epidermis. ...
Article
Advances in aesthetic laser technology over the past two decades have allowed physicians to choose from a variety of fluences, spots sizes, pulse durations and wavelengths in treating hair, vascular lesions and pigmentation. With the development of Multiplex (MPX), a proprietary technology that sequentially combines wavelengths to potentiate clinical effect, now clinicians have the ability to choose treatment with a single wavelength or a combination. Combining synergistic wavelengths in multiplex modality allows for a safer treatment profile with lower total fluence used to treat cutaneous pigmented and vascular lesions and for laser hair removal. A second advancement has been integrated cooling which enables epidermal melanin protection while deliv-ering treatment to the chromophore being targeted. The purpose of this article is to present a novel dual wave-length workstation employing multiplex technology which effectively treats hair, telangiectasias and lentigenes.
... The efficacy and safety of diode lasers for the long-term removal of hair has been shown. [12][13][14][15][16][17][18] Repetitive treatments have been found to provide greater hair reduction than a single treatment 13 at 20-month follow-up, and treatment outcomes are comparable with those obtained with the alexandrite laser 19 and Nd:YAG laser. 20 The bikini area has been treated with the alexandrite laser, 10,21 normal-mode ruby laser, 22 long-pulsed ruby laser, 23 Nd:YAG laser, 24,25 and diode laser. ...
Article
The efficacy, safety, and treatment time of a new, high-speed, very long-pulsed (90-200 ms) 810-nm diode laser have been evaluated for the rapid removal of bikini hair. Study participants (n520) received 5 treatments at 6-week intervals. Hairs were counted from pretreatment and posttreatment photo- graphs. Among the 16 people who completed the study, the median hair count at 6 months after the fifth treatment was significantly lower than the median pretreatment hair count (P,.0001). The median hair count reduction fractions increased after the second treatment and continued to increase at 3- and at 6-month follow-up visits, indicating continual improvement. Hair count reduction fractions achieved a median of 87.6% (mean584.4%) at 6 months after the final treatment. Adverse effects were not observed, and treatment time was short. The 810-nm diode laser has been observed to safely and efficiently remove unwanted hair from the bikini area.
... Bouzari and colleagues did not find any significant difference in efficacy between the alexandrite and diode lasers when treating patients with skin types I to V. 20 Similarly, Handrick and Alster found equivalent clinical and histologic responses using a long-pulse alexandrite and longpulse diode laser in treating skin types I to IV, although the diode had more side effects than the alexandrite laser. 21 Treating patients with skin types I to IV sequentially with the diode followed by alexandrite laser did not produce greater mean hair reduction than an equivalent number of treatments with the alexandrite laser alone, although the former was associated with more side effects of folliculitis, erythema, and blistering. 22 The long-pulse alexandrite laser and long-pulse diode laser have been shown to have similar efficacy whether used individually or sequentially when treating skin types I to IV. ...
Article
Background: Unwanted hair growth is a common aesthetic problem. Laser hair removal has emerged as a leading treatment option for long-term depilation. Objectives: To extensively review the literature on laser hair removal pertaining to its theoretical basis, current laser and light-based devices, and their complications. Special treatment recommendations for darker skin types were considered. Materials and methods: A comprehensive literature search related to the long-pulse alexandrite (755 nm), long-pulse diode (810 nm), long-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG; 1,064 nm), and intense pulsed light (IPL) system, as well as newer home-use devices, was conducted. Results: The literature supports the use of the alexandrite, diode, Nd:YAG and IPL devices for long-term hair removal. Because of its longer wavelength, the Nd:YAG is the best laser system to use for pigmented skin. Further research is needed regarding the safety and efficacy of home-use devices. Conclusion: Current in-office laser hair removal devices effectively provide a durable solution for unwanted hair removal.
... These side effects are temporary and usually resolve within 3 to 4 days. 22,23 Not all patients experience adverse effects, and when calculating the benefit-risk ratio, they can be ignored. Shaving or other methods of hair removal do not ensure permanent hair removal; long-term or permanent (70%) hair removal is provided by laser treatment, 24 which is very effective in preventing the recurrence of pilonidal sinus disease. ...
Article
Full-text available
Abstract Pilonidal disease has been treated surgically and by various other methods for many years. The most important problem associated with such treatment is recurrence, but cosmetic outcome is another important issue that cannot be ignored. Today, crystallized phenol is recognized as a treatment option associated with good medical and cosmetic outcomes. We hypothesized that the addition of laser depilation to crystallized phenol treatment of pilonidal disease might increase the rate of success, and this study aimed to determine if the hypothesis was true. Patients who were treated with crystallized phenol and 755-nm alexandrite laser depilation were retrospectively analyzed. In total, 42 (31 male and 11 female) patients were treated with crystallized phenol and alexandrite laser depilation and were followed up between January 2009 and January 2012. In all, 38 patients (90.5%) had chronic disease and 4 (9.5%) had recurrent disease. Among the patients, 26 (61.9%) recovered following 1 crystallized phenol treatment, and the remaining patients had complete remission following repeated treatment. Some patients needed multiple treatments, even up to 8 times. None of the patients had a recurrence during a mean 24 months (range, 6-30 months) of follow-up. Whatever method of treatment is used for pilonidal disease, hair cleaning positively affects treatment outcome. The present results support the hypothesis that the addition of laser depilation (which provides more permanent and effective depilation than other methods) to crystallized phenol treatment (a non-radical, minimally invasive method associated with very good cosmetic results) can increase the effectiveness of the treatment and also reduce the recurrence rate of the disease.
... They concluded there was no statistical difference in their efficacy [50]. Similarly, this was reported in other studies [51][52][53][54][55]. Alexandrite laser hair removal was also compared with electrolytic epilation, which showed an average clearance rate of the hairs of 74% by laser and 35% by electrolysis after 6 months, rendering alexandrite laser hair removal a more reliable and practical solution than electrolysis as it is 60-times faster and less painful than electrolysis [56]. ...
Article
Full-text available
Alexandrite laser is a pulsed laser system that emits light in bursts of low energy but with peak powers that are much greater than in continuous mode lasers. It can be either short-pulsed in the range of 50-100 ns (Quality-switched) or long-pulsed in the range of 2 to 40 ms. It has many clinical applications in medicine of which dermatology is one of those fields that alexandrite laser therapy made a difference in treating various skin conditions. It is effective in the clearance of pigmented lesions such as Nevus of Ota, nevomelanocytic nevi, lentigines and freckles; removal of tattoos of blue to black color; removal of unwanted hair in various skin types; and treatment of telangectasias. Reported complications are not specific to alexandrite laser and some are temporary, which can resolve with time.
Article
Zusammenfassung Die Fotoepilation zählt zu den meistgefragten nichtchirurgischen Eingriffen in der ästhetischen Dermatologie. Haarlose, glatte Beine gelten dabei als Schönheitsideal. Fotoepilation mittels Laser oder hochenergetischer Blitzlampen (sog. Intensed-Pulsed-Light-Geräte) stellt ein sicheres und effektives Verfahren dar. Der Wirkmechanismus beruht auf dem Prinzip der selektiven Fotothermolyse, wobei eine gezielte thermische Schädigung pigmentierter Haarfollikel unter Schonung des umliegenden Gewebes erfolgt. Melaninpigment des Haarschaftes absorbiert als Zielchromophor Licht eines speziellen Wellenlängenspektrums und führt durch Wärmediffusion zur Schädigung der für das Haarwachstum wichtigen Stammzellen im äußeren Haarwurzelschaft. Patienten müssen über die Notwendigkeit wiederholter Behandlungen sowie den häufig nur partiellen und temporären Haarverlust aufgeklärt werden. Dunkle Terminalhaare bei hellen Hauttypen lassen sich effektiv entfernen. Bei dunklen Hauttypen besteht aufgrund des erhöhten epidermalen Melaninvorkommens ein erhöhtes Risiko für Nebenwirkungen wie Verbrennungen, Dyspigmentierungen und Narben. Sehr feine, helle oder rote Haare lassen sich kaum mit konventionellen Fotoepilationsverfahren entfernen. Haarentfernungsgeräte für den Heimgebrauch sind eine kostengünstige, einfach anzuwendende Alternative, weisen aber im Vergleich zur professionellen Fotoepilation eine geringere Effektivität auf.
Article
The evolution of modern laser and light-based systems has mirrored the demand for clinically effective treatments and the need for safer technologies with reduced postoperative recovery, side effects, and complications. With each new generation of lasers, more selective tissue destruction can be achieved with reduced unwanted sequelae. Patient selection and preparation, operator technique, and expeditious recognition and management of post-treatment side effects are paramount in avoiding complications and patient dissatisfaction. An overview of important variables to consider for dermatologic laser treatments are presented in order to provide a framework to reduce the severity and duration of possible post-treatment side effects and complications.
Chapter
Lasers for hair removal are a fast-growing area in cosmetic dermatology. Selective photothermolysis allows for targeting of specific chromophores while minimizing cutaneous damage. Treatment of individuals should be individualized based on anatomical area, skin and hair color, by varying the wavelength, fluence, pulse duration, spot size, and cooling technique of the laser.
Article
One underreported, rare side effect of laser hair removal, is paradoxical hypertrichosis. It is largely unknown what the long-term outcomes are of patients who develop this complication. We report a 21-year-old, Fitzpatrick II, male patient, who had patchy areas of dark hair affecting various body areas. An Alexandrite 755 nm laser was used to address the desired areas at energies between 20–22 J/cm² at 10–12 week intervals over a course of 7 treatments. After 3 treatments, the patient noted a significant increase in the density and length of hairs involving the back, shoulders, neck and upper arms. The patient was followed on a bi-annual basis, without further epilatory intervention. After 10 years, the areas of paradoxical hair growth were sparser compared to immediate post-treatment but remained denser compared to pre-treatment. This case illustrates improvement in the condition over time without intervention. Further studies are needed to determine the etiopathogenesis of this phenomenon.
Article
Background: Acne keloidalis nuchae (AKN) is a dermatological condition characterized by follicular-based papules and pustules that later form hypertrophic or keloid-like scars. Laser-assisted hair reduction such as 810-nm diode laser and 1,064-nm Nd:YAG laser have been used for treating AKN with promising results. Objective: To evaluate the therapeutic effect and safety of alexandrite laser in the treatment of different lesions of AKN. Methods: Seventeen male patients with AKN received 6 sessions of 755-nm alexandrite laser. Papule and pustule count, keloidal plaque size, pliability, tenderness, and itching were assessed at the fourth session and 4 weeks after the sixth session. Patient satisfaction and Dermatology Life Quality Index (DLQI) questionnaire were performed at the end of treatment. Patients were followed up for 3 months after the final treatment. Results: There was a significant decrease in the mean papule, pustule count, keloidal plaque size, and pliability at the fourth and sixth laser sessions when compared with baseline. Reduction of the hair density in the treated area is the only complication observed, which was accepted by the patients because of its reversible course. There was a statistically significantly higher percentage of improvement in the early lesions (papulopustular) compared with late (keloidal plaque) lesions. By the end of laser sessions, DLQI scores were significantly reduced. Temporary hair loss was noted in 4 patients in the treated sites. No lesional recurrence was detected in the follow-up period. Conclusion: Using 755-nm alexandrite laser for treatment of AKN is a safe and effective procedure with low recurrence rates. Alexandrite laser can significantly improve the quality of life of those patients suffering from this disfiguring chronic disorder.
Article
Laser-based photoepilation of dark skin types demands a delicate combination of appropriate light wavelengths and spot size to achieve optimal epidermal-to-follicular energy absorption ratios. This prospective study assessed the axillary, arm, thigh, and back hair clearing ef cacy of the LightSheer In nity 1060 nm diode laser in 10 Fitzpatrick skin type IV-V patients. Each area was treated up to ve times, at 4-6-week intervals, after which immediate skin responses and adverse events were recorded. Hair count, color and coarseness were assessed before each treatment session, as well as 1, 3, and 6 months following the last session. Both patients and the treating physician rated the degree of improvement with time, and patients also ranked their satisfaction with the treatment outcome. Percent hair reduction from baseline gradually increased with treatment and peaked at 74.6%, 68.4%, and 65.7% for axillary, arm and thigh regions, respectively, 6 months following the last treatment session. Baseline hair growth patterns precluded effective selection of a representative area for hair counting. Patients satisfaction was consistently higher for axillary hair clearance rates, followed by thigh and arm responses. Throughout the follow-up period, the investigator rated 50-67% of the treated axillae as presenting "good" or "very good" hair clearance, and provided similar ratings for 67% of the treated thigh regions at both the 1 and 6 month follow-up sessions. Immediate responses to treatment were mild to moderate and short-lived and no incidents of brosis or scarring were reported. Taken together, the LightSheer In nity 1060 HS Handpiece provided for an ideal ef cacy-safety balance in treating dark-skinned patients, providing for long-term hair clearance with minimal downtime. J Drugs Dermatol. 2016;15(11):1427-1434.
Article
Background and objective: Many laser devices have been developed over the past decades for various skin conditions. However, variations in the technical skill of physicians for laser skin treatment delivery have not yet been evaluated. This study evaluates the differences in omission and overlap percentages during simulated laser hair removal treatments among physicians at two clinics. Materials and methods: A laser beam detection kit was developed to record and collect laser irradiation from a diode laser device. Eight physicians (primary private clinic 4, tertiary referral hospital 4) were recruited to perform 80 trials of laser delivery simulation. The simulation process was captured in video frames by a camera built inside of the detection kit. The laser distribution map was reconstructed, and each physician's performance result was determined by a computer calculation. Results: Various assumption tests showed that each physician had different laser delivery skills. Four physicians from clinic A had an average omission rate of 13.4%, and four physicians from clinic B had an average omission rate of 19.7%. Regarding the average overlap rate of the two clinics, clinic A had a higher rate than clinic B (26.1% vs. 14.6%). Conclusions: The study's findings confirmed the differences of the technical skills among the physicians and between the two clinics. The proposed computer-assisted evaluation of technical skill is useful for assessing physicians' performance during laser skin treatments.
Chapter
IntroductionEssential ConceptsPearls and ProblemsConclusions
Chapter
The goal of skin resurfacing is the rejuvenation of the skin by stimulation of its regenerative potential. The outer layer of epidermis is ablated in order to improve the quality of the skin. Sun damage is removed and age-related changes are improved in skin resurfacing. In general, there are several methods for resurfacing procedures: mechanical, known as dermabrasion, chemical peel, electrical, known as radiowave ablation and photoablation, normally referred to as laser skin resurfacing. The difference between these procedures is the varying results, the side effects, the difficulty in performance and reproducibility. Laser skin resurfacing is a well-controlled and precise procedure that shows defined, predictable results with fewer risks of complications [10,15,40]. There are laser wavelengths suitable for laser skin resurfacing. One is the CO2 laser (10 600 nm) and the other is the Er:YAG (erbium:yttrium-aluminium-garnet) laser (2940 nm). The coefficient of absorption in water is more than 16 times higher in the EnYAG wavelength. This results in a more complete absorption in a thinner layer of tissue with ablation of up to 30 μm and a thermal damage zone of less than 50 μm.
Chapter
Der Erfolg von Laser- und IPL-(″intense pulsed light″-)Behandlungen zur Haarentfernung ist von der vorhandenen Melaninmenge im Haarschaft abhängig. Der ideale Patient für die lasergestützte Haarentfernung hat helle Haut mit schwarzen, dicken Haaren. Die Beweislage für die Wirksamkeit der Laser- und Photoepilation ist sehr umfangreich; Anfang 2009 lagen 43 kontrollierte Studien dazu vor. Laserbehandlung und Photoepilation sind den herkömmlichen Methoden wie Rasur, Wachsbehandlung und Elektrolyse überlegen. Wiederholungsbehandlungen verbessern den Wirkungsgrad der Laser- und Photoepilation. Für den Rubin-, Alexandrit- und Diodenlaser sowie den Neodymium:Yttrium-Aluminium-Granat-Laser (Nd:YAG-Laser) und für IPL-Geräte konnte mehrfach eine kurzfristige Wirksamkeit bei der Haarentfernung für einen Zeitraum von bis zu 6 Monaten nachgewiesen werden. Des Weiteren liegen Beweise für eine langfristige Wirksamkeit von Wiederholungsbehandlungen mit Alexandrit- und Diodenlasern sowie langgepulsten Nd:YAG-Lasern vor, die länger als 6 Monate anhielt. Weiße, graue und rote Haare sprechen nicht ausreichend auf Standardbehandlungen an. Eflornithin, topisches Melanin und die photodynamische Therapie können jedoch neue Behandlungsoptionen für diese schwierig zu entfernenden Haartypen darstellen, obwohl es bisher noch an maßgeblicher Evidenz dazu mangelt. Zum jetzigen Zeitpunkt gibt es keine Evidenz für eine vollständige und dauerhafte Haarentfernung. Die Patienten sollten vor der Behandlung mit Laser und IPL über das zu erwartende Ergebnis aufgeklärt werden, um eine realistische Erwartungshaltung zu ermöglichen. Geräte für den Hausgebrauch, die von den Patienten selbst bedient werden können, sind auf dem Vormarsch.
Article
Lasers are versatile, commonly used treatment tools in dermatology. While it is tempting to follow manufacturer's guidelines or other "recipes'' for laser treatment, this approach alone can be a recipe for disaster. Specific and immediate skin responses or endpoints exist and are clinically useful because they correlate with underlying mechanisms that are either desirable (ie, therapeutic), undesirable (ie, warning signs of injury or side effects), or incidental. The observation of clinical endpoints is a safe and reliable guide for appropriate treatment. This article presents the warning endpoints during specific dermatologic laser treatments, and the accompanying article presents the therapeutic endpoints, their underlying mechanisms, and the utility of these endpoints.
Chapter
Die Behandlung mit dem Laser wird vom Patienten nach wie vor intensiv nachgefragt. Obwohl die meisten überwiegend kosmetischen Eingriffe das Hautorgan betreffen, bieten inzwischen beinahe sämtliche Fachdisziplinen dermatologische Laserleistungen an. Der Dermatologe kann sich in dieser Situation nur durch überzeugende Darstellung seiner Fachkompetenz behaupten. Da gerade in der Lasertherapie praktisches Anwenderwissen wesentlich ist, wurde auf der 18. Fortbildungswoche erstmals ein Kurs angeboten, der auf theoretische Darstellung des gegenwärtigen Wissensstands verzichtet und sich statt dessen in interaktiver Form am Patienten mit konkreten Fragen und Problemen der Laserbehandlung auseinandersetzt. Komplementär hierzu sind die zum Thema Laser gehaltenen Plenarvorträge zu sehen. Der potenziellen Laseranwender kann somit einmal im Rahmen praktischer Kurse am Patienten aus eigener Anschauung und durch vorgetragene oder publizierte Studienergebnisse verwertbares Wissen gewinnen.
Chapter
Die Photoepilation mittels Laser und IPL (Intense-pulsed-light-)Technologie ist mittlerweile ein etabliertes Verfahren in der dermatologischen-ästhetischen Therapie. Bekannt ist auch das Gerätespektrum, das vom langgepulsten Rubin-, Alexandrit-und Diodenlaser über den 1064-nm-Nd:YAG-Laser bis hin zur IPL-Technologie reicht. Im gütegeschalteten Modus zeigte der 1064-nm-Nd:YAG-Laser in der Vergangenheit zwar die geringste Nebenwirkungs-, dafür aber auch die schlechteste Clearancerate [1,13,15,16]. Die Verlängerung der Impulszeit auf bis zu 50 ms hat den ersten Veröffentlichungen zufolge die Effektivität dieses Lasertyps jedoch wesentlich verbessern können [8, 9,14].
Chapter
Hirsutism is represented by excessive growth of the coarse hairs in women, distributed in a male-like pattern. Hypertrichosis is represented by excessive growth of coarser and longer hair than is normal for the age, sex and race of the person. The hair growth cycle has three phases: anagen, catagen and telogen. The anagen phase is the growth phase, the catagen phase is the regression phase and the telogen phase is the rest phase. The hair follicle is the most susceptible to IPL treatment during the anagen phase. The melanin is the target chromophore for hair removal. There are three types of melanosomes present in the hair. Erythromelanin granules are present in red hair while eumelanin and pheomelanin granules are found in varying proportions in blond and dark hair. The targets for hair removal are the dermal papilla and the bulge area. The heat-induced destruction of the hair shaft leads to hair “dropout”. The partial injury to the germinative zone leads to telogen-shock response, prolonged telogen dropout, and development of dystrophic hairs which are thinner in texture and have variable pigmentation. Multiple IPL treatments are usually needed. If no improvement is obtained after 5–6 sessions, interrupting the treatment should be considered. The darker the skin and the brighter the hair (Fig. 7.1), the less effective the treatment will be.
Article
Lasers for hair removal are a fast-growing area in cosmetic dermatology. Selective photothermolysis allows for targeting of specific chromophores while minimizing cutaneous damage. Treatment of individuals should be individua­lized based on anatomical area, skin and hair color, by varying the wavelength, fluence, pulse duration, spot size, and cooling technique of the laser.
Article
This chapter reviews the critical hair structures and hair growth processes that are either involved in converting the laser photons to thermal energy, or are part of the biochemical and molecular systems affected by the thermal energy. High laser fluences and energy levels can cause permanent reduction in hair desired by many consumers, and it has the potential for collateral skin damage. The level of efficacy versus dermal side effects is generally dependent on the difference in eumelanin levels between epidermis and the target hair follicle. To understand the mechanism of laser-induced changes in hair growth reduction, whether temporary or permanent, or changes in hair character after treatment, or to determine the treatment regimen for maximal hair reduction benefit, it is important to understand the impact that laser has on key biochemical and molecular targets that regulate hair growth, character, and cycling. At the basic biochemical and molecular level, the released thermal energy from laser treatment can either simply kill the fiber producing cells of the hair follicle by causing denaturation of cellular proteins and phospholipid membranes or can modify the molecular mechanisms and signaling pathways that control the growth and cycling of the hair follicle.
Article
Introduction: Diode laser and intense pulsed light are among the most frequently used technologies for epilation. Objective: To compare diode laser with intense pulsed light in axillary epilation. Methods: Patients with phototypes II and III (n = 15) were subjected to 3 regular sessions of intense pulsed light (695 nm) - Quantum HR® Platform (Lumenis, Yokneam, Israel) in the right axilla and diode laser (810 nm) - Light Sheer® (Lumenis, Yokneam, Israel) in the left axilla. The number of axillary hairs were counted before and after treatment, and patients were administered a questionnaire about adverse effects, pain and satisfaction. Results: Both techniques provided a similar and significant reduction in hair density. The pain score and degree of inflammation were significantly higher for intense pulsed light (p < 0.01 and p = 0.03, respectively). There was a significant correlation between the fluence employed, the severity of pain, and the degree of inflammation for the two techniques (p < 0.05). The patients considered the final results to be similar, however more side effects were attributed to intense pulsed light. There was no difference in the proportion of preference between the two methods (p = 0.80). Conclusion: The two techniques produced similar results, but the diode laser caused less pain and fewer side effects compared to intense pulsed light.
Article
This chapter discusses melanogenesis in skin and hair follicle, how melanin granules or melanosomes are formed, some basic thermal principles describing how hair follicles respond to heat, the relevance of using the Fitzpatrick scale, various cooling systems designed to protect the epidermis, and the efficacy and safety of various lasers and IPL systems for darker skin types. Laser hair removal allows a physician or trained professional to treat large areas of the body quickly, with long-lasting or permanent reduction in hair growth. These reductions in growing hair are caused by the interaction of the laser with the hair melanin. While initially developed for the ideal contrast of dark hair against a fair skin background, an increasing demand is foreseen to treat all individuals regardless of base skin color, particularly in the United States, where the population is becoming more ethnically diverse. Significant hair growth reduction has been reported in people with darker skin types; however, the interaction of the laser with skin melanin must be taken into account to prevent long-lasting side effects. Permanent changes in pigmentation and skin texture, focal atrophy, and scarring are some of the adverse effects that have been reported with improper laser use. As the understanding of the variations in response in people of color to the laser grows, these side effects associated with laser hair reduction can be reduced.
Conference Paper
Despite the widespread use of lasers for hair removal there is little data published on the incidence of side effects from this treatment. We aimed to generate data on a large number of patients receiving laser hair removal to obtain an accurate assessment of the incidence and type of side effects resulting from treatment. A multicentre prospective study of patients attending for laser hair removal was conducted to determine incidence of side effects in relation to skin type and laser(s) used. Laser hair removal is associated with a low incidence of side effects which are self-limiting in the majority of cases. Highest incidence of side effects was seen in darker skinned patients treated with the long pulsed ruby laser. Laser hair removal is inherently safe. For darker Fitzpatrick skin types the long pulsed Nd:YAG laser is preferred to the ruby laser.
Article
BACKGROUND: Advances in laser technology over the past several years have led to the development of numerous lasers for the treatment of unwanted hair. Laser wavelength is a key factor influencing treatment efficacy and complication rates. OBJECTIVE: To compare the efficacy and safety of laser hair removal using three different laser systems. METHODS: A retrospective study of 805 consecutive laser-assisted hair removal treatments, conducted on 75 patients by means of either a long-pulsed Nd:YAG, a long-pulsed alexandrite, or a long-pulsed diode laser is reported. All patients were evaluated at least 3 months after the last treatment, and their present conditions were compared with the 1st-day photographs. RESULTS: The mean hair reduction was 42.4%, 65.6%, and 46.9% in Nd:YAG, alexandrite, and diode lasers, respectively. When the number of treatment sessions was taken into account, the efficacy of alexandrite and diode lasers was not significantly different, whereas both systems were more efficacious than Nd:YAG. Neither of the laser systems showed better results for a particular skin type. The occurrence of side effects was not significantly different between three laser systems. CONCLUSION: Both long-pulsed alexandrite and long-pulsed diode laser systems are effective in the treatment of unwanted hair, and they are more efficacious than Nd:YAG laser.
Article
Despite the widespread use of lasers for hair removal there are few data published on the incidence of side effects from this treatment.Objective The aim of this study was to generate data on a large number of patients receiving laser hair removal to obtain an accurate assessment of the incidence and type of side effects resulting from treatment.MethodsA multicenter prospective study of patients presenting for laser hair removal was conducted to determine incidence of side effects in relation to skin type and laser or lasers used.ResultsLaser hair removal is associated with a low incidence of side effects that are self-limiting in the majority of cases. The highest incidence of side effects was seen in patients with darker skin treated with the long-pulsed ruby laser.Conclusions Laser hair removal is inherently safe. For darker Fitzpatrick skin types the long-pulsed neodymium:yttrium-aluminum-garnet laser is preferred to the ruby laser.
Article
Background: Nonsurgical procedures for facial rejuvenation vastly outnumber surgical procedures among board-certified plastic surgeons; interest in nonsurgical cosmetic procedures is rapidly growing for patients and physicians, with less down time, less scars, and potentially less cost. Nonsurgical procedures are often a gateway for patients into more invasive surgical procedures. Providing patients with a comfortable, pleasant experience increases the chance of referrals and return for future procedures, surgical and nonsurgical. Methods: In this review article, we describe basic principles for providing patients with a pleasant, minimal pain experience during nonsurgical facial rejuvenation procedures. The procedures are grouped into injectables, noninvasive devices, and minimally invasive devices, and basic guidelines for pain management are provided. Results: A review of each nonsurgical facial rejuvenation procedure is provided with typical patient perception of discomfort and methods to reduce or eliminate pain. This article covers the most popular procedures performed in many plastic surgery offices but is not inclusive of all devices and technologies available on the market. Conclusions: A wide range of nonsurgical options exist for rejuvenation, and there is nearly as much variety in pain associated with these procedures. As with any procedure that potentially may lead to pain or anxiety for a patient, it is important to assess patient's pain tolerance preprocedurally to determine the level of intervention needed. Providing a relaxed, calm environment and satisfactory pain control helps to reduce anxiety and improve the overall perception of the procedure and provider.
Article
Unwanted hair is a common problem for which different types of light therapy have been developed as the treatment of choice. Since 1996, when the American Food and Drug Administration approved the first laser therapy for depilation, much progress has been made in light-based technology and lasers. Lasers and intense pulsed light sources with red or near infrared wavelengths (600 to 1200 nm) are the most widely used for removing hair as they target the melanin of the hair shaft, hair follicle epithelium, and hair matrix. The aim of this review is to describe and compare the different photodepilation methods currently available.
Article
There has been a remarkable development and evolution of laser technology, leading to adaptation of lasers for medical use and the treatment of skin problems and disorders. Many treatments that required incisional surgery and other invasive methods are now preferentially treated with a laser. Although laser advances have resulted in the availability of some amazing tools, they require the clinical skill and judgment of the clinician for their optimal use. This article provides a clinically oriented overview of many of the lasers valuable in facial plastic surgery. Basic science, clinical adaptations, and patient management topics are covered.
Article
Background: Safe and efficient options for removing unwanted hair are in great demand. Laser devices and intense pulsed light (IPL) sources are the most commonly used treatment modalities. Yet, only a few randomized controlled trials (RCTs) comparing laser and IPL devices are available, and RCTs with long-term results are missing from the literature. Objectives: To compare the safety and long-term efficacy of diode lasers (DL) and IPL sources for axillary hair removal, we conducted an intrapatient, left-to-right, assessor-blinded and controlled trial. Methods: IPL (Ellipse Flex PPT; Danish Dermatological Development, Hoersholm, Denmark; λem=600-950 nm) and DL (LightSheer XC system; Lumenis Inc., Santa Clara, CA, U.S.A.; λem=800 nm) treatments were evaluated in 30 study participants (skin type II-III) with unwanted axillary hair growth. Six treatments with each device were carried out at 4-week intervals. Final assessment was conducted 12 months after the last treatment by means of hair counts using close-up photographs. The primary endpoint was reduction in hair growth, analysed on an intention-to-treat and last-observation-carried-forward basis (n=30), and secondary endpoints were patient-rated efficacy, treatment-related pain, adverse effects and treatment duration. Results: Both devices significantly reduced hair counts. Mean reductions from baseline (3 and 12 months after the last treatment) were 59·7% and 69·2% for DL and 42·4% and 52·7% for IPL treatment (P<0·01), respectively. DL treatment induced significantly more pain [3·7±2·1 (DL) vs. 1·6±1·4 (IPL); P<0·01; visual analogue scale] but could be conducted faster [33·1±3·8 s (DL) vs. 40·1±5·0 s (IPL); P<0·01]. No severe side-effects were observed for either therapy. Conclusions: Both DL and IPL treatments are highly effective, long lasting and safe. DL was found to be more effective than IPL treatment. DL treatment was more painful but less time-consuming than IPL therapy.
Article
Laser (or light) hair removal, also referred to as photoepilation, is the most commonly used laser or light-based cosmetic medical procedure. The extended theory of selective photothermolysis is the basic principle for destruction of hair follicles using light. In this type of laser application the chromophore is follicular melanin. Several types of lasers and light sources have been effective for hair reduction, including the ruby, alexandrite, diode, and neodymium:yttrium-aluminum-garnet lasers and broadband, intense pulsed light sources. This article provides a broad overview of how hair can be removed using light, with an emphasis on practical considerations.
Article
To evaluate the safety and efficacy of a home-use hair removal diode laser (TRIA Beauty, Inc., Dublin, CA) in a multiple treatment regimen. Thirteen indicated adults with naturally brown or black hair and Fitzpatrick skin type I-IV received 8 monthly treatments with the diode laser at three fluences, with a fourth area left untreated as a control. Quantitative hair counts were made at each treatment visit and periodically for 12 months after the last treatment. The treated sites exhibited statistically significant hair count reduction that generally increased with each treatment and remained stable during the 1 year follow-up period. The mean percent hair count reduction was 47%, 55%, and 73% at 1 month after the last treatment and 44%, 49%, and 65% at 12 months after the last treatment at fluences of 7, 12, and 20 J/cm(2) , respectively, compared to control. Eighty-six percent (86%) of subjects had greater than 30% hair reduction and 38% had >80% hair reduction at 12 months post-treatment. At the same time point, 31% of subjects reported complete (100%) hair removal and 69% reported that the hair that did regrow was less noticeable due to being finer and/or lighter. The only observed side effects were erythema and edema that were mild, transient, and self-resolving usually within a few hours. The home-use diode laser was safe and highly effective at permanently reducing unwanted hair.
Article
Full-text available
To determine the most effective treatment parameters for laser-assisted hair removal using a Q-switched neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Prospective study to determine the effectiveness of Q-switched ND:YAG laser-assisted hair removal under varying pretreatment protocols. Hair growth was assessed after laser treatment, and the results were compared with those of wax epilation at 4, 12, and 24 weeks. A private ambulatory laser facility and academic referral center. Laser-assisted hair removal was performed under 4 different pretreatment conditions. Eighteen areas of unwanted body and facial hair from 12 study subjects were divided into 4 quadrants. Wax epilation followed by application of a carbon-based solution and exposure to Q-switched Nd:YAG laser radiation was performed on 1 quadrant. A second quadrant was wax epilated and exposed to Q-switched Nd:YAG laser radiation without prior carbon solution application. A third quadrant was exposed to laser radiation alone, and a final quadrant was wax epilated to serve as the control. Follow-up evaluations at 1, 3, and 6 months consisted of photographic documentation, manual hair counts, and patient hair-density estimates. Percentage of hair regrowth as assessed by objective hair counts and patient subjective evaluations. Mean percentage of hair regrowth at 1 month was 39.9% for the wax-carbon-laser quadrant, 46.7% for the wax-laser quadrant, 66.1% for the laser-alone quadrant, and 77.9% for the wax control quadrant. The percentage of hair regrowth approximately doubled by 3 months but was significantly delayed in all laser-treated quadrants regardless of pretreatment protocol. Full hair regrowth in all anatomic locations was observed by month 6. Patient subjective evaluations of hair density closely approximated hair count data. No adverse effects or long-term complications were observed. A single hair-removal treatment with the Q-switched Nd:YAG laser is safe and effective in delaying hair growth for up to 3 months. Although the combination of pretreatment wax epilation and topical carbon solution application was effective, laser irradiation alone, with or without wax epilation, also provided a significant delay in hair growth.
Article
Full-text available
To examine the clinical, histological, and immunohistological effects of flashlamp photoepilation. Nonrandomized control trial with blinded histological study and follow-up of 1 to 20 months. Private academic practice. Sixty-seven subjects (10 males and 57 females) with areas of excess body hair. Single (9 subjects) or multiple (58 subjects) treatments (noncoherent, 590-1200 nm, 2.9-3.0 milliseconds, 40-42 J/cm2) to hairy skin. From subjects given a single treatment, biopsy samples were taken immediately after treatment and at different intervals for up to 20 months. Clinical measures include hair counts and morphologic features before and after treatment. Histological measures include terminal-vellus and anagen-other ratios, hair shaft diameter, and morphologic features (routine and immunohistochemical detection of bcl-2, bax, p53, Ki67, cyclin D1, and hsp70) before and after treatment. Mean hair loss after photoepilation was 49%, 57%, and 54% for a single treatment and 47%, 56%, and 64% for multiple treatments at follow-up of less than 3 months, 3 to less than 6 months, and 6 months or longer, respectively (P<.05 for all comparisons). Transient erythema was seen in all subjects; no scarring occurred. Histologically, treatment caused morphologic damage confined to hair follicles and shafts. Terminal-vellus and anagen-telogen ratios, mean hair shaft diameter, and immunohistochemical profiles were not significantly modified by treatment. Treatment did not alter other skin adnexa, epidermis, or vessels. Flashlamp treatment leads to significant, longlasting epilation. The predominant mechanism seems to be via selective photothermal damage to large, pigmented hair follicles rather than induction of a programmed state of follicular cycle arrest or follicular miniaturization.
Article
Despite widespread demand for efficient, reliable methods of eliminating unwanted hair from the face and body, available options were limited until the recent development of laser-assisted hair removal systems. This is a review of the various types of hair removal methods available today with an emphasis on laser-assisted hair removal.
Article
Background: Multiple laser systems are available for the purpose of hair removal. Objective: The purpose of this study was to determine the safety and long-term efficacy of the 800 nm, pulsed diode laser at reducing hair count. Methods: Fifty volunteers, primarily Fitzpatrick skin types II and III, with dark brown or black hair, were treated with a diode laser (800 nm, 10-40 J/cm2, 5-30 msec, 9 mm 9 mm, 5 degrees C chilled handpiece). Each subject had eight treatment sites at varying fluences and pulse durations, as well as a varying number of treatments and pulses. Hair counts were obtained at each site at baseline, 1, 3, 6, 9, and an average of 20 months after treatment. Results: After one treatment, hair regrowths ranged from 22 to 31% at the 1-month follow-up visit, then remained stable between 65 and 75% from the 3-month to the averaged 20-month follow-up. After two treatments there were relatively longer growth delays, with hair regrowths plateauing beginning at 6 months after treatment and ranging from 47 to 66% for the remainder of the follow-up evaluations. Side effects were limited to pigmentary changes, transient in subjects with skin types II and III. Conclusions: This 800 nm diode laser with a chilled sapphire tip and variable pulse duration is safe and effective for long-term hair reduction in individuals with skin types II and III.
Article
Background. Laser-assisted hair removal is becoming the treatment of choice for removing unwanted hair.Objective. The purpose of this work was to determine the long-term efficacy of the long-pulsed infrared (LPIR) laser at shortened treatment intervals for the treatment of bikini hair.Methods. Eleven patients received five treatments at 3-week intervals to the right groin using the LPIR laser. Laser parameters were held constant for all treatments: 10 mm spot size, 20 J, and 20-msec pulse duration. Results were evaluated 1 year after the last laser treatment. Hair counts were performed.Results. The average patient had a 78% clearance of hair noted at 1 year with no evidence of scarring or pigmentary changes.Conclusions. A simulated model of cutaneous hair follicles provides evidence that shorter treatment intervals (3 weeks) may be preferable for more complete destruction of the hair follicle bulb and bulge.
Article
Electrolysis has been performed since 1875. Electrolysis satisfactorily removes hair from women with static hair growth, but women with hirsutism often require concomitant management of their hormonal problems. We have found the blend method to be the most effective modality for permanent hair removal. Attention must be given to proper electrolysis technique, including accurate needle insertion and appropriate intensities and duration. Scarring does not occur with properly performed electrolysis. Hair is not an electrical conductor and electronic tweezers do not result in permanent hair removal. Shaving 1 to 5 days before electrolysis greatly increases efficacy because it ensures that only growing anagen hairs are epilated. The recent availability of EMLA (eutectic mixture of local anesthetics) has been beneficial in reducing the sensations of electrolysis. The availability of prepackaged, presterilized, individual electrolysis needles has greatly reduced the need for more complicated sterilization procedures.
Article
Although many temporary treatments exist for hirsutism and hypertrichosis, a practical and permanent hair removal treatment is needed. Our purpose was to study the use of normal-mode ruby laser pulses (694 nm, 270 microseconds, 6 mm beam diameter) for hair follicle destruction by selective photothermolysis. Histologically assessed damage in ex vivo black-haired dog skin after the use of different laser fluences was used to design a human study; 13 volunteers with brown or black hair were exposed to normal-mode ruby laser pulses at fluences of 30 to 60 J/cm2, delivered to both shaved and wax-epilated skin sites. An optical delivery device designed to maximize light delivery to the reticular dermis was used. Hair regrowth was assessed at 1, 3, and 6 months after exposure by counting terminal hairs. Fluence-dependent selective thermal injury to follicles was observed histologically. There was a significant delay in hair growth in all subjects at all laser-treated sites compared with the unexposed shaven and epilated control sites. At 6 months, there was significant hair loss only in the areas shaved before treatment at the highest fluence. At 6 months, four subjects had less than 50% regrowth, two of whom showed no change between 3 and 6 months. Transient pigmentary changes were observed; there was no scarring. Selective photothermolysis of hair follicles with the normal-mode ruby laser produces a growth delay consistent with induction of prolonged telogen with apparently permanent hair removal in some cases.
Article
Many individuals seek to decrease facial and body hair density. Although a variety of epilating methods are available, improved techniques would be of interest to patients and physicians alike. To determine the safety and clinical efficacy of a new laser-based method of hair removal. A Q-switched Nd:YAG laser was used to scan skin with increased hair after applying a topical carbon-based solution. Thirty-five healthy, adult volunteers were treated with a single treatment to selected facial, neck, and axillary sites. Twelve weeks after a single treatment, integrated site scores revealed that the majority of patients had over 25% fewer hairs. The 12-week mean percentage of hair reduction, based on anatomic sites, ranged up to 66% and 44% as judged by physicians and subjects, respectively. Adverse events were minimal and temporary. Topical suspension-assisted Q-switched Nd:YAG laser therapy reduces hair density after a single treatment. Advantages include its speed, technical ease, and minimal adverse effects.
Article
The long-term epilation of hair is the goal of several lasers and intense pulsed light systems. The purpose of the study is to use the EpiLight Hair Removal System to assess long-term epilation and to assess its safety profile following a single treatment session. Patients received a single treatment with the Epilight Hair Removal System after entering the patient's skin type, skin color, hair color, and hair density into the system's computer software. Treatment parameters include various wavelengths of light, pulse duration, pulse delay, and energy fluence. Thirty-seven subjects received a single treatment using one of four cut-off filters consisting of two to five pulses with energies of 34-55 J/cm2. The results of a single treatment show hair clearances occurring immediately and over a 12-week study period. Approximately 60% hair removal was noted at 12 weeks. The EpiLight Hair Removal System is an effective and safe method for long-term epilation of unwanted hair.
Article
It has been shown that normal mode ruby laser pulses (694 nm) are effective in selectively destroying brown or black pigmented hair follicles in adult Caucasians. This study investigated how the various stages of the hair follicle growth cycle influence follicle destruction by ruby laser treatment, using a model of predictable synchronous hair growth cycles in the infantile and adolescent mice. A range of ruby laser pulse fluences was delivered during different stages of the hair growth cycle, followed by histologic and gross observations of the injury and regrowth of hair. Actively growing and pigmented anagen stage hair follicles were sensitive to hair removal by normal mode ruby laser exposure, whereas catagen and telogen stage hair follicles were resistant to laser irradiation. Selective thermal injury to follicles was observed histologically, and hair regrowth was fluence dependent. In animals exposed during anagen, intermediate fluences induced nonscarring alopecia, whereas high fluences induced scarring alopecia. The findings of this study suggest treatment strategies for optimal laser hair removal.
Article
To assess the permanence of hair removal by normal-mode ruby laser treatment. Hair removal was measured for 2 years after a single treatment with normal-mode ruby laser pulses (694 nm, 270 microseconds, 6-mm beam diameter). Six test areas on the thighs or backs of 13 volunteers were exposed to normal-mode ruby laser pulses at fluences of 30 to 60 J/cm2 delivered to both shaved and wax-epilated skin. In addition, there was a shaved and wax-epilated control site. Terminal hairs were manually counted before and after laser exposure. Transient alopecia occurred in all 13 participants after laser exposure, consistent with induction of telogen. Two years after laser exposure, 4 participants still had obvious, significant hair loss at all laser-treated sites compared with the unexposed shaved and wax-epilated control sites. In all 4 participants, there was no significant change in hair counts 6 months, 1 year, and 2 years after laser exposure. Laser-induced alopecia correlated histologically with miniaturized, velluslike hair follicles. No scarring and no permanent pigmentary changes were observed. Permanent, nonscarring alopecia can be induced by a single treatment with high-fluence ruby laser pulses. Miniaturization of the terminal hair follicles seems to account for this response.
Article
Laser hair removal is rapidly becoming a widely used modality. Clinical studies are needed to assess these hair removal systems. The long-pulsed ruby laser is one such modality for the removal of unwanted hair. To evaluate the efficacy of the long-pulsed ruby laser (694 nm, 3-msec pulsewidth, 7- or 10-mm spot size) in removing unwanted hair, and to provide treatment guidelines for the proper utilization of this laser system. Forty-eight areas of unwanted facial and body hair from 25 patients with blonde, brown, or black hair were treated with the long-pulsed ruby laser at fluences between 10 and 40 J/cm2. Hair regrowth was measured at 4 weeks after the first treatment, 4 weeks after the second treatment, 4 weeks after the third treatment, and 16 weeks after the third treatment by counting the number of terminal hairs compared with baseline pretreatment values. All complications and treatment outcomes were documented. The mean percent of regrowth after the first treatment was 65.5%, 41% after the second treatment, and 34% after the third treatment. Overall, regardless of skin type or targeted body region, patients who underwent three treatment sessions demonstrated an average 35% regrowth in terminal hair count compared with baseline pretreatment values 6 months after initial therapy. Long-pulsed ruby laser treatment resulted in significant hair growth delay in most cases. Repeated laser treatments produced an increased number of vellus hairs, an increase in growth delay, and a decreased percentage of hair regrowth.
Article
The recent development of numerous laser-assisted hair removal techniques has produced confusion in the field of cutaneous laser surgery. A systematic review of the hair removal laser systems currently available is attempted. Appropriate patient selection, treatment protocols, and discussion of each system's advantages, disadvantages, and complications is provided. Techniques involving the use of selective Q-switched Nd:YAG and long-pulsed alexandrite and ruby laser systems provide a significant delay in hair growth. With further technologic advances and understanding of proper treatment parameters and intervals, it is expected that permanent hair removal may eventually be possible.
Article
The methods of hair removal vary between simple inexpensive means of home treatment (shaving, plucking, depilatories) to expensive and potentially time-consuming means used by paraprofessionals, nurses, and/or physicians (electrolysis, lasers, x-ray). The ways in which these different methods induce hair removal, the duration of such removal, and the nuances between devices within the same category of methods are discussed. (J Am Acad Dermatol 1999;40:143-55.) Learning objective: At the completion of this learning activity, participants should be cognizant of the different control mechanisms for hair growth and how the different means of hair removal affect these. Readers will also become familiar with the different types of electrolysis and lasers currently used for hair removal and the advantages and disadvantages of each.
Article
To evaluate the effects on disruption of hair growth of the non-coherent filtered flashlamp intense pulsed light (IPL) source. Twenty-eight sites on 23 patients with Fitzpatrick type I-III were enrolled using a single treatment IPL followed for three months post-treatment. Another 56 on 48 patients with Fitzpatrick skin types I-V randomly enrolled for two treatments one month apart and followed for six months. Prior to beginning treatment and at each follow-up visit hair counts were obtained by averaging three 1-cm2 areas on a clear acetate template placed over the skin. Repeat hair counts and photographs were obtained at 2, 4, 8, and 12 weeks for the single treatment protocol and at additional 4, 5, and 6 months for the double treatment protocol. Parameters utilized were a 2.8-3.2 millisecond pulse duration typically for three pulses with thermal relaxation intervals of 20-30 milliseconds with a total fluence of 40-42 J/cm2. For the double treatment protocol hair clearance of 64% was achieved immediately following the second treatment. By week 8 reduction of hair counts was 42%. At 6 months, hair counts were reduced by 33%. Non-coherent IPL is an effective modality for long-term hair removal. IPL is safe with minimal side effects of epidermal injury or pigmentation change.
Article
Several laser systems with varying wavelengths, pulse durations, and energy fluences are currently utilized for hair removal. However, the ideal laser parameters and treatment candidates for photoepilation remain largely unknown. The medical literature lacks a wealth of experimental data to sufficiently document the long-term safety and efficacy of laser-assisted hair removal. This study examines the clinical efficacy and side effect profile of long-pulsed alexandrite laser-assisted hair removal utilizing laser pulse durations of either 5, 10, or 20 milliseconds (ms). Laser-assisted hair removal was performed on 36 subjects with a long-pulsed alexandrite laser. Areas of unwanted hair growth on the face, back, and legs were divided linearly into four 1 cm2 or 2 cm2 quadrants. Experimental regions included a control quadrant and three additional quadrants, which were treated with the alexandrite laser using an average fluence of 18 J/cm2, with a 10 mm spot size at either a 5, 10, or 20 ms pulse duration. Hair counts and photographs were obtained before treatment, immediately following irradiation, 1 week and 1, 3, and 6 months postoperatively. All laser-treated quadrants displayed a significant delay in hair regrowth compared to control nontreated quadrants at postoperative week 1 and months 1 and 3. Hair counts were reduced by 66% at 1 month, 27% at 3 months, and 4% at 6 months. No significant differences in clinical efficacy or side effect profiles were observed between treatment quadrants, yet a trend towards less post-treatment erythema and hyperpigmentation was noted with the 20 ms pulse duration. Equivalent long-term hair removal for up to 6 months was achieved with the long-pulsed alexandrite laser at 5, 10, and 20 ms pulse durations at an average fluence of 18 J/cm2. Side effects were limited and transient.
Article
Laser-assisted hair removal has become popularized using wavelengths in both the red and infrared regions of the electromagnetic spectrum. These photoepilation devices target follicular melanin or an exogenous pigment placed within the follicle resulting in thermal damage to the hair follicle and shaft. However, melanocytes and keratinocytes located within the superficial layers of the skin also absorb red and infrared laser radiation. This may result in unwanted epidermal injury during the hair removal process. The purpose of this study was to examine a large patient population to determine the frequency of side effects using 3 different hair removal laser systems with various wavelengths, pulse durations, and treatment protocols. A retrospective chart review and digital photographic analysis of the side effects resulting from 900 consecutive laser-assisted hair removal treatments delivered over a 24-month study period, by means of either a Q-switched Nd:YAG laser with pretreatment wax-epilation and topical carbon solution, a long-pulse ruby laser with a contact cooling tip, or a long-pulse alexandrite laser are reported. Treatment pain, erythema, edema, hypopigmentation and hyperpigmentation, blistering, crusting, erosions, purpura, and folliculitis were observed. The majority of undesirable tissue effects occurred on tanned skin or in Fitzpatrick skin phototypes III and higher. The ruby and alexandrite laser systems resulted in the majority of side effects seen. The effects of seasonal variations, anatomic treatment location, and sun exposure were striking within the ruby and alexandrite laser groups. No infections, scarring, or long-term complications occurred. Laser-assisted hair removal is a safe procedure when patient characteristics such as skin type, anatomic location, and sun-exposed or tanned skin are considered during selection of laser treatment parameters. Lasers emitting wavelengths with high melanin absorption capabilities should be used in a conservative manner when treating patients with dark skin phototypes or suntans. No long-term complications, infections, or scarring occurred in this study population.
Article
Fifty-one patients of skin type I to IV with facial hirsutism received treatment with the normal-mode ruby laser (950-micros pulse; 4-mm spot; mean fluence, 49 J/cm(2); maximum fluence, 66 J/cm(2)). For each patient, one site was treated once only, and a second site was treated 4 times at 4-week intervals. After 48 weeks, 46 patients were available for assessment. After a single treatment, hair counts were reduced to a mean of 45% at 4 weeks (pretreatment median of 63 hairs down to 26), increased to 80% (median, 51 hairs) at 12 weeks, were 65% (median, 41 hairs) at 24 weeks, and were 59% (median, 35 hairs) at 48 weeks. Four weeks after 3 treatments, the hair counts had reduced to a mean of 30% (pretreatment median of 68 hairs down to 15). Twelve weeks after 4 treatments, the hair counts had increased to 45% (median, 24 hairs) and were 39% after 36 weeks (median, 22.5 hairs). No anesthesia was needed. Treatment tolerance improved with consecutive visits, allowing higher fluences to be used. Hyperpigmentation developed in 9 patients, which had faded completely in 8 patients at the end of the study. One patient showed hypopigmentation. Depressions in the skin below the jaw line developed in 5 patients, which resolved completely within 4 to 32 weeks. We conclude that normal-mode ruby laser treatment is well tolerated and leads to significant improvement of facial hirsutism, which is maintained for at least 48 weeks. Repeated treatments result in greater clinical effects.
Article
Laser-assisted hair removal is becoming the treatment of choice for removing unwanted hair. The purpose of this work was to determine the long-term efficacy of the long-pulsed infrared (LPIR) laser at shortened treatment intervals for the treatment of bikini hair. Eleven patients received five treatments at 3-week intervals to the right groin using the LPIR laser. Laser parameters were held constant for all treatments: 10 mm spot size, 20 J, and 20-msec pulse duration. Results were evaluated 1 year after the last laser treatment. Hair counts were performed. The average patient had a 78% clearance of hair noted at 1 year with no evidence of scarring or pigmentary changes. A simulated model of cutaneous hair follicles provides evidence that shorter treatment intervals (3 weeks) may be preferable for more complete destruction of the hair follicle bulb and bulge.
Evaluation of hair removal methods
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What factors really matter in laser hair removal?
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Electrolysis: observations from 13 years and 140,000 hours of experience
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